- Cedars-Sinai (CA)
- …people throughout Los Angeles and beyond. **Req ID** : 11588 **Working Title** : Claims Examiner - Managed Care **Department** : MNS Managed Care ... **Job Description** The Claims Examiner is responsible for accurately...is a leader in providing high-quality healthcare encompassing primary care , specialized medicine and research. Since 1902, Cedars-Sinai has… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Examiner III is an advanced-level role responsible for the detailed and accurate processing, review, and ... claims processing, coding, and regulatory compliance. The Claims Examiner III will handle the most...pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to… more
- New York State Civil Service (Schenectady, NY)
- NY HELP Yes Agency Workers' Compensation Board Title Workers' Compensation Examiner (NY HELPS), WCB Item #8741 Occupational Category No Preference Salary Grade 14 ... Description Under the general supervision of the Associate Workers' Compensation Examiner and direct supervision of the Senior Workers' Compensation Examiner… more
- New York State Civil Service (Schenectady, NY)
- NY HELP Yes Agency Workers' Compensation Board Title Workers' Compensation Examiner (NY HELPS), WCB Item #8940 Occupational Category No Preference Salary Grade 14 ... 12305 Duties Description Under the direction of a Senior Examiner , 18The position of Workers Compensation Examiner ...mail sorting or distribution, as well as review of claims files for settlement and hearing scheduling tasks;* Assist… more
- Intermountain Health (Las Vegas, NV)
- …of claims processing, claims logging, or customer service experience in a managed care environment. - and - Demonstrated minimum of 100 SPM on ten key ... **Job Description:** The Claims Examiner I is responsible for...hourly rate dependent upon experience. $18.93 - $27.45 We care about your well-being - mind, body, and spirit… more
- Marriott (Bethesda, MD)
- …and assess reserve adequacy to ensure accuracy, reasonableness, and timeliness. * Ensure claims are directly managed in a timely and effective manner, using ... and/or responsibilities. The Senior Director acts as a liaison between claims department and operations promoting service excellence through education, training, and… more
- Option Care Health (Bannockburn, IL)
- …compliance programs. + Direct experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines. + Proficiency with audit software ... no limit to the growth of your career.** Option Care Health, Inc. is the largest independent home and...large datasets, such as related to healthcare operations, billing, claims , and patient information to support Compliance activities and… more
- LA Care Health Plan (Los Angeles, CA)
- …in conducting financial audits. At least 5 years of related experience in the managed health care industry. Preferred: Health Care experience. Skills ... Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of… more
- Sedgwick (Fort Worth, TX)
- …reports, claim adjustments, provider requests and operational expense check requests. + Queues claims for Managed Care ; transfers payment allocations; and ... Coordinator **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple...logins and the applicable security access for the company's claims management systems by determining the validity for incoming… more
- Prime Therapeutics (Tallahassee, FL)
- …Examiner credential preferred. + Bachelor's degree preferred. + Prefer knowledge of managed health care business model and processes, preferably in behavioral ... Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the...for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded… more
- Molina Healthcare (Nampa, ID)
- …investigative and law enforcement procedures with emphasis on fraud investigations. + Knowledge of Managed Care and the Medicaid and Medicare programs as well as ... ASSOCIATION** : + Health Care Anti-Fraud Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all… more